Harnessing Protocolized Adaptation in Dissemination: Successful Implementation and Sustainment of the Veterans Affairs Coordinated-Transitional Care Program in a Non-Veterans Affairs Hospital.

التفاصيل البيبلوغرافية
العنوان:	Harnessing Protocolized Adaptation in Dissemination: Successful Implementation and Sustainment of the Veterans Affairs Coordinated-Transitional Care Program in a Non-Veterans Affairs Hospital.
المؤلفون:	Kind AJ; Geriatrics Division, Department of Medicine, School of Medicine and Public Health, William S Middleton Hospital Madison, Madison, Wisconsin.; School of Nursing, William S Middleton Hospital Madison, Madison, Wisconsin.; School of Pharmacy, William S Middleton Hospital Madison, Madison, Wisconsin.; Department of Veterans Affairs, Geriatric Research Education and Clinical Center, William S Middleton Hospital Madison, Madison, Wisconsin., Brenny-Fitzpatrick M; University of Wisconsin Hospitals and Clinics, William S Middleton Hospital Madison, Madison, Wisconsin., Leahy-Gross K; University of Wisconsin Hospitals and Clinics, William S Middleton Hospital Madison, Madison, Wisconsin., Mirr J; Geriatrics Division, Department of Medicine, School of Medicine and Public Health, William S Middleton Hospital Madison, Madison, Wisconsin.; Department of Veterans Affairs, Geriatric Research Education and Clinical Center, William S Middleton Hospital Madison, Madison, Wisconsin., Chapman E; Geriatrics Division, Department of Medicine, School of Medicine and Public Health, William S Middleton Hospital Madison, Madison, Wisconsin., Frey B; University of Wisconsin Hospitals and Clinics, William S Middleton Hospital Madison, Madison, Wisconsin., Houlahan B; University of Wisconsin Hospitals and Clinics, William S Middleton Hospital Madison, Madison, Wisconsin.
المصدر:	Journal of the American Geriatrics Society [J Am Geriatr Soc] 2016 Feb; Vol. 64 (2), pp. 409-16. Date of Electronic Publication: 2016 Jan 25.
نوع المنشور:	Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't
اللغة:	English
بيانات الدورية:	Publisher: Blackwell Science Country of Publication: United States NLM ID: 7503062 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1532-5415 (Electronic) Linking ISSN: 00028614 NLM ISO Abbreviation: J Am Geriatr Soc Subsets: MEDLINE
أسماء مطبوعة:	Publication: Malden, MA : Blackwell Science Original Publication: New York [etc.]
مواضيع طبية MeSH:	Veterans, Transitional Care/organization & administration, Aged ; Female ; Hospitals, Veterans ; Humans ; Male ; Models, Theoretical ; Patient Readmission/statistics & numerical data ; Telephone ; United States ; United States Department of Veterans Affairs
مستخلص:	The Department of Veterans Affairs (VA) Coordinated-Transitional Care (C-TraC) program is a low-cost transitional care program that uses hospital-based nurse case managers, inpatient team integration, and in-depth posthospital telephone contacts to support high-risk patients and their caregivers as they transition from hospital to community. The low-cost, primarily telephone-based C-TraC program reduced 30-day rehospitalizations by one-third, leading to significant cost savings at one VA hospital. Non-VA hospitals have expressed interest in launching C-TraC, but non-VA hospitals differ in important ways from VA hospitals, particularly in terms of context, culture, and resources. The objective of this project was to adapt C-TraC to the specific context of one non-VA setting using a modified Replicating Effective Programs (REP) implementation theory model and to test the feasibility of this protocolized implementation approach. The modified REP model uses a mentored phased-based implementation with intensive preimplementation activities and harnesses key local stakeholders to adapt processes and goals to local context. Using this protocolized implementation approach, an adapted C-TraC protocol was created and launched at the non-VA hospital in July 2013. In its first 16 months, C-TraC successfully enrolled 1,247 individuals with 3.2 full-time nurse case managers, achieving good fidelity for core protocol steps. C-TraC participants experienced a 30-day rehospitalization rate of 10.8%, compared with 16.6% for a contemporary comparison group of similar individuals for whom C-TraC was not available (n = 1,307) (P < .001). The new C-TraC program continues in operation. Use of a modified REP model to guide protocolized adaptation to local context resulted in a C-TraC program that was feasible and sustained in a real-world non-VA setting. A modified REP implementation framework may be an appropriate foundational step for other clinical programs seeking to harness protocolized adaptation in mentored dissemination activities. (© 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.)
References:	Fam Community Health. 2009 Jan-Mar;32(1 Suppl):S83-92. (PMID: 19065098) JAMA. 1999 Feb 17;281(7):613-20. (PMID: 10029122) Health Aff (Millwood). 2012 Dec;31(12):2659-68. (PMID: 23213150) J Am Geriatr Soc. 2003 Apr;51(4):549-55. (PMID: 12657078) J Am Geriatr Soc. 2004 May;52(5):675-84. (PMID: 15086645) Fed Pract. 2014 Feb 1;31(2):30-34. (PMID: 24639602) Am J Public Health. 2003 Aug;93(8):1261-7. (PMID: 12893608) Jt Comm J Qual Patient Saf. 2008 Apr;34(4):228-43. (PMID: 18468362) Depress Res Treat. 2012;2012:325249. (PMID: 23050134) AIDS. 2004 May 21;18(8):1179-86. (PMID: 15166533) Implement Sci. 2007 Dec 09;2:42. (PMID: 18067681) Arch Intern Med. 2006 Sep 25;166(17):1822-8. (PMID: 17000937) Am J Public Health. 2000 Jul;90(7):1082-8. (PMID: 10897186) Qual Health Care. 1999 Sep;8(3):177-83. (PMID: 10847875)
معلومات مُعتمدة:	2P50AG033514-06 United States AG NIA NIH HHS; UL1 TR000427 United States TR NCATS NIH HHS; K23AG034551 United States AG NIA NIH HHS; K23 AG034551 United States AG NIA NIH HHS; UL1 RR025011 United States RR NCRR NIH HHS; P50 AG033514 United States AG NIA NIH HHS
فهرسة مساهمة:	Keywords: dissemination; implementation science; nursing; rehospitalization; transitional care
تواريخ الأحداث:	Date Created: 20160126 Date Completed: 20160630 Latest Revision: 20181113
رمز التحديث:	20231215
مُعرف محوري في PubMed:	PMC4760859
DOI:	10.1111/jgs.13935
PMID:	26804896
قاعدة البيانات:	MEDLINE

View record at Wiley

Full Text Finder

الوصف
تدمد:	1532-5415
DOI:	10.1111/jgs.13935